Waist Circumference In Group Research Articles

Association of obesity profiles with type 2 diabetes in Chinese adults: Findings from the China health and nutrition survey.

AimsTo examine longitudinal associations of obesity profiles, continuous BMI, and waist circumference (WC) with the risk of type 2 diabetes in Chinese adults.MethodsData were derived from three waves (2009, 2015, and 2018) of the China Health and Nutrition Survey, and 3,595 adults aged 18–65 years who participated in at least two waves of the survey and had completed data were analyzed. Obesity profiles included BMI- or WC-related single obesity and combined obesity. Combined obesity was categorized into six groups including Group 1 with normal BMI and WC, Group 2 with normal BMI but pre-abdominal obesity, Group 3 with normal BMI but abdominal obesity, Group 4 with abnormal BMI (overweight and general obesity) and normal WC, Group 5 with abnormal BMI and pre-abdominal obesity, and Group 6 with abnormal BMI and abdominal obesity. Three-level mixed-effects logistic regressions with random intercept stratified by gender and restricted cubic splines were performed to examine ORs and 95%CIs for the risk of type 2 diabetes.ResultsIn men, compared with subjects of Group 1, those in Group 3 had higher risk, with an OR of 4.83 (95% CI: 1.99–11.74), followed by those in Group 6 (OR = 4.05, 95%CI: 2.32–7.08) and Group 5 (OR = 2.98, 95%CI: 1.51–5.87) after adjusting for all potential confounders. For women, the subject of Group 6 had highest risk (OR = 8.79, 95%CI: 4.04–19.12), followed by Group 3 (OR = 3.30, 95%CI: 1.23–8.86) and Group 5 (OR = 3.16, 95%CI: 1.21–8.26). No significant association between abnormal BMI and normal WC (Group 4) was observed in both genders. Type 2 diabetes risk increased steeply at BMI of 23.5 kg/m2 and 22.5 kg/m2 or higher, and WC of 82.0 cm and 83.0 cm or higher in Chinese adult men and women, respectively (p for overall <0.001).ConclusionChinese adults with pre-abdominal or abdominal obesity had a relative high risk of type 2 diabetes independent of BMI levels. Lower BMI (≤23.5 kg/m2 for men and ≤22.5 kg/m2 for women) and lower WC (82.0 cm for men and ≤83.0 cm for women) values than the current Chinese obesity cut-offs were found to predict the risk of type 2 diabetes. These findings urge to inform WC modification and optimization of early screening guidelines.

Waist circumference and risk of Parkinson’s disease

Although many studies support the association of obesity with neurodegenerative diseases, such as Parkinson’s disease (PD), there are limited data regarding the association between abdominal obesity and PD, with mixed findings. The aim of this study was to examine the association of waist circumference (WC) with the risk of PD incidence. We retrospectively analyzed a large-scale nationwide cohort of 6,925,646 individuals aged ≥40 years who underwent the Korean National Health Screening during 2009. We performed multivariable Cox proportional hazards regression to evaluate the association of WC and abdominal obesity with PD risk and calculated hazard ratios (HRs) with 95% confidence intervals (CIs) of PD incidence. During a median follow-up period of 8.35 years, 33,300 cases of PD developed. PD incidence was positively associated with increases in WC (P for trend < 0.001). The risk of PD incidence tended to elevate as WC increased (P for trend < 0.001), indicating that the adjusted HRs of PD incidence in the highest WC group versus the reference group was 1.16 (95% CI, 1.10–1.23), whereas it was 0.91 (95% CI 0.84–0.98) in the lowest WC group. Individuals with abdominal obesity were significantly associated with an increased PD risk (HR 1.10, 95% CI: 1.07–1.13). These associations persisted even after adjustment for body mass index and stratification by sex. Even among non-obese individuals, abdominal obesity was associated with a higher PD risk (adjusted HR 1.13, 95% CI: 1.09–1.18). Taken together, higher WC and abdominal obesity were associated with increased PD risk. Even in non-obese individuals, abdominal obesity was associated with an increased PD risk.

Waist circumference and mortality or cardiovascular events in a general Korean population.

Obesity is associated with cardiovascular diseases and is a risk factor for all-cause mortality. Until now, the associations between abdominal obesity and mortality or cardiovascular disease (CVD) incidence have not been conclusive. We aimed to evaluate the associations between waist circumference (WC) and mortality or CVD incidence in a general Korean population. We analyzed a total of 204,068 adults older than 40 years of age who had undergone a national health examination at least once from 2009 to 2018 in the Korean National Health Insurance Service Cohort. WC was divided into five categories (< 80, 80-84.9, 85-89.9, 90-94.9, ≥ 95 cm). Hazard ratios for death and CVD incidence were calculated using Cox proportional hazards models. In men, WC and overall mortality showed a reverse J-shaped association. In women, the association between WC and overall mortality was not significant. For both men and women, WC was not associated with the risk of cardiovascular mortality. Contrary to the mortality trend, CVD incidence was positively associated with WC in both men and women, and the risk of the CVD incidence was the lowest in subjects with a WC < 80 cm. WC exhibited a significant J-shaped association with overall mortality in men, where subjects who had central obesity showed a lower rate of mortality than those in the lowest or highest WC group. The risk of incident CVD showed a positive association with central obesity, where the lowest risk was observed for subjects in the lowest WC group in a general Korean population.

Obesity and abdominal obesity are risk factors for airway obstructive diseases in Korean women: nationwide population-based cohort study.

Existing studies show that women are more susceptible to chronic obstructive pulmonary disease (COPD) and asthma, and that obesity affects the risk of these airway obstructive diseases. We aimed to determine the effect of body mass index (BMI) and waist circumference (WC) on COPD and asthma development in premenopausal and postmenopausal women. This nationwide population-based cohort study included 1,644,635 women ages ≥30 years without diagnosis of COPD or asthma, who underwent national cancer screening in 2009. We classified them as premenopausal and postmenopausal women based on their menopause status at the time of cancer screening. Baseline BMI and WC were measured, and they were classified into five BMI groups (<18.5 kg/m2, 18.5-23 kg/m2, 23-25 kg/m2, 25-30 kg/m2, and ≥30 kg/m2) and WC groups (<60 cm, 65-75 cm, 75-85 cm, 85-95 cm, and ≥95 cm). The hazard ratios (HRs) for COPD and asthma were measured for each group. Regardless of the menopausal status, the high BMI and WC groups had a significantly higher COPD and asthma incidence than that of the normal group, and the HRs increased further with increases in BMI and WC. However, the HR in the underweight group was significantly higher among the postmenopausal women. The HR for asthma in the obese group was significantly higher for both premenopausal and postmenopausal women. The HR for COPD was significantly higher in the group with a WC of ≥95 cm for both premenopausal and postmenopausal women, respectively; the HR for asthma was also significantly higher in this group. Obesity and abdominal obesity are risk factors for COPD and asthma in premenopausal and postmenopausal Korean women. Controlling weight and maintaining a healthy body shape can help prevent COPD and asthma in women.

Does Obesity Affect the Outcomes of Clinically Localized Prostate Cancer in the Era of Extraperitoneal Robot-Assisted Radical Prostatectomy?

Purpose: Obesity has been proven to affect the outcomes in open radical prostatectomy. However, the relationship between obesity and the outcomes of robot-assisted radical prostatectomy (RARP) was not conclusive. Herein, we aimed to investigate the impact of obesity on the clinical outcomes after RARP. Materials and Methods: From April 2016 to June 2020, 164 patients underwent RARP by a single experienced surgeon at our institute. Patients with previous transurethral resection of prostate (n = 30), hernioplasty (n = 13), and transperitoneal RARP (n = 26) were excluded. Finally, 105 patients were enrolled and divided into different groups according to their body mass index (BMI) and waist circumference (WC) using the definition of Taiwan National Health Institute. BMI was categorized into three groups (normal: BMI &lt;24, overweight: BMI between 24 and 27, and obese: BMI ≥27 [kg/m2]). WC was categorized into two groups (normal: WC &lt;90 and central obesity: WC ≥90 [cm]). Perioperative outcomes and functional outcomes including preoperative, postoperative erectile function, and postoperative continence status were evaluated. Results: Among BMI groups, 29 patients were normal, 43 patients were overweight, and 33 patients were obese. Console time and sum time showed a significant difference in different BMI groups (P = 0.034 and 0.016, respectively). Of the 101 patients with available magnetic resonance imaging, 74 patients' WC were normal, and 27 patients were central obese. Blood loss in central obesity group was significant more than normal WC group (300 ml vs. 200 ml, P = 0.04). No significant differences were observed in pathological and functional outcomes in both groups. Conclusion: Obesity and central obesity seemed to result in longer operation time and more blood loss in extraperitoneal RARP while functional outcomes can be maintained regardless of the obesity degree. Large-scale studies are necessary to further explore the relationship between obesity and the outcomes of RARP in future.

Relationship between waist circumference and cardiorespiratory fitness in Chinese children and adolescents: Results from a cross-sectional survey

BackgroundThis article assessed the relationship between waist circumference (WC) and cardiorespiratory fitness (CRF) of children and adolescents aged 7–18 years. MethodsUsing a stratified cluster random sampling method, 92,574 children and adolescents (47,364 males and 45,210 females) were extracted. CRF was measured by performance in the 20 m shuttle run test (20mSRT) and the subsequent estimation of maximal oxygen consumption (V˙O2max) using the Léger equations. Participants were divided into five groups of WC percentiles and three groups of CRF percentiles by the Lambda Mu Sigma (LMS). The correlation between WC and CRF was examined by one-way ANOVA and curvilinear regression analysis. ResultsWC increased with age, while V˙O2max showed an age-related decline. Controlling for gender, urban, and rural factors, for children and adolescents aged 10–12, 13–15, and 16–18 years, the V˙O2max Z-score of the normal WC group was significantly higher than the very low WC group (P < 0.05). Controlling for gender, urban, and rural factors, for participants aged 7–18 years, the V˙O2max Z-score of the normal WC group was significantly higher than the high WC group and the very high WC group (P < 0.05). ConclusionsIt generally shows a “parabolic” trend between WC-Z and V˙O2max-Z. The CRF among children and adolescents in the normal WC group is significantly higher than that in the low and the high WC groups.

Association Between Obesity and Cardiovascular Disease in Elderly Patients With Diabetes: A Retrospective Cohort Study.

Some studies have suggested that patients with type 2 diabetes mellitus (T2DM) concomitant with obesity have better clinical outcomes than normal-weight patients with T2DM. We evaluated associations among obesity, cardiovascular disease (CVD) events, and mortality in elderly patients with T2DM without CVD. This retrospective observational study from 2009 to 2017, with a mean follow-up of 7.26 years, included 249 903 elderly (≥ 65 years) patients with T2DM and no preexisting CVD from the Korean National Health Information Database. We categorized subjects according to body mass index (BMI) and waist circumference (WC) and analyzed a composite of stroke, myocardial infarction, and all-cause death using Cox proportional hazards regression analysis, adjusting for baseline covariates. The incidence rate of composite primary outcomes was 30.95/1000 person-years. The primary outcome risk had an L-shaped and a U-shaped association with BMI and WC, respectively. In the multivariable Cox proportional hazard models, the risk of primary composite outcomes in the highest BMI group (≥ 30 kg/m2; hazard ratio [HR] = 0.824; 95% CI, 0.794-0.855) was lower than in the normal BMI group (≥ 18.5 and < 23 kg/m2). Conversely, that in the highest WC group (≥ 100 cm/≥ 95 cm; men/women; HR = 1.434; 95% CI, 1.384-1.486) was higher than in the normal WC group (< 90 cm/< 85 cm; men/women). Our study with elderly patients with diabetes results suggest that while BMI is an inadequate risk indicator for outcomes related to obesity, WC is a suitable alternative.

Association of body mass index and waist circumference with risk of ischemic stroke in adults in China: a prospective cohort study

Objective: To explore the relationship between body mass index (BMI), waist circumference (WC) and the risk for ischemic stroke in adults in China. Methods: A total of 36 632 adults were selected from 60 surveillance areas (25 urban surveillance areas and 35 rural surveillance areas) in China Chronic Disease Surveillance Project in 2010 for a follow up study from 2016 to 2017 based on the baseline data in 2010. The follow up was completed for 27 762 adults. Cox proportional hazard regression model was used to analyze the association of body mass index and waist circumference with the risk for ischemic stroke in different populations. The death and hypercholesterolemia cases were excluded by sensitivity analysis. Results: A total of 26 907 adults were included in the analysis. During the follow up period, 1 128 ischemic stroke events were observed (491 in men and 637 in women). After adjusting the related confounding factors and taking normal BMI/normal WC group as the reference, the risk for ischemic stroke increased by 50% in normal BMI/abdominal obesity group (HR=1.50, 95%CI:1.07-2.08), 51% in overweight/abdominal obesity group (HR=1.51, 95%CI:1.20-1.91), 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.09-1.96), and 63% in normal BMI/abdominal obesity group (HR=1.63, 95%CI:1.12-2.38), 56% in overweight/abdominal obesity group (HR=1.56, 95%CI: 1.20-2.03) and 45% in obesity/abdominal obesity group (HR=1.45, 95%CI: 1.05-2.01) respectively in men and in men with CVD risk factors. There was no increased risks in the overweight/normal WC group. The risk increased by 40% in overweight/abdominal obesity group (HR=1.40, 95%CI:1.15-1.72) and 46% in obesity/abdominal obesity group (HR=1.46, 95%CI:1.16-1.83), and 35% in overweight/abdominal obesity group (HR=1.35, 95%CI:1.08-1.69) and 30% in obesity/abdominal obesity group (HR=1.30, 95%CI:1.01-1.67) respectively in women and women with CVD risk factors. There were no risk increases in overweight/normal WC group and normal BMI/abdominal obesity group. Sensitivity analysis results showed no change. Conclusion: Overweight/obesity with abdominal obesity or abdominal obesity alone could increase the risk for stroke in men, and overweight/obesity with abdominal obesity could increase the risk for ischemic stroke in women; suggesting that BMI and WC should be used jointly to evaluate obesity in population for weight control to prevent ischemic stroke.

Associations of body mass index, waist circumference and waist-to-height ratio with cognitive impairment among Chinese older adults: Based on the CLHLS

BackgroundFew studies have been conducted on the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cognitive impairment among Chinese older adults through a prospective design. ObjectiveThis study was aimed to evaluate the associations of BMI, WC, and WHtR with cognitive impairment. MethodsWe included participants aged 65 years and older in 2014 at baseline and 2018 follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). BMI, WC, and WHtR were calculated from measured weight, height, and waist circumference. Mini-Mental State Examination was utilized to assess cognitive impairment. Modified Poisson regression was used for calculating prevalence ratios, risk ratios, and 95% confidence intervals. ResultsA total of 5156 participants were included in 2014 at baseline. The prevalence of cognitive impairment was 42.5%, 26.7%, and 21.2% in underweight, normal-weight, and overweight/obesity participants defined by BMI categories, respectively, and 24.1% and 26.8% in central obesity participants defined by WC and WHtR cutoffs, respectively. Prospectively, participants with underweight were more likely to suffer from cognitive impairment (RR = 1.258, 95% CI: [1.016, 1.559]), but no risk was found among participants with overweight/obesity after adjustment. Regardless of whether covariates were adjusted or not, no effect on cognitive impairment was found in participants with WC and WHtR groups in the follow-up survey. ConclusionsUnderweight may be a significant risk factor for the cognitive impairment of Chinese older adults. Weight management programs targeting older adults should attach importance to achieving and maintaining optimal body weight and improving cognitive function.

Gender Differences in the Relationship of Waist Circumference to Coronary Artery Lesions and One-Year Re-Admission Among Coronary Artery Disease Patients with Normal Body Mass Index.

PurposeThe study explored the association of waist circumference (WC) with the severity of cardiovascular diseases and hospital readmission of coronary artery disease (CAD) patients with normal body mass index (BMI).Patients and Methods213 female and 431 male normal-BMI CAD patients were enrolled and assigned in three groups based on their gender-specific WC tertiles. Their cardiovascular risk factors and coronary angiography characteristics were analyzed in a cross-sectional study, and the gender-specific relationship between WC and one-year re-admission rate was prospectively explored.ResultsThe cross-sectional analysis showed that for male normal-BMI CAD patients, diabetes and dyslipidemia prevalence, Apo B/A1, hs-CRP, and uric acid levels triglycerides-glucose index, the incidence of left main disease, three vessel disease, calcification lesion, total occlusive lesion, and complex lesion, as well as Gensini score was in the order of WC tertile 3 > WC tertile 2 > WC tertile 1. In addition, male normal-BMI CAD patients in the highest WC tertile were at an increased risk of severe CAD (OR=2.21), and the correlation was still statistically significant even after adjusting for potential cardiovascular risk factors (OR=1.87). For female normal-BMI CAD patients, as the WC tertiles increased, uric acid level, the prevalence of three vessel disease, diffuse lesion, and complex lesion gradually increased (P <0.05), but no significant difference was found in the risk of severe CAD among different WC groups (all P >0.05). Prospective analyses showed that the higher the WC tertile was, the higher the one-year re-admission rate in men, but not in women, and after adjusting for other risk factors, men with the highest WC tertile showed more than twice the risk of patients with the lowest WC tertile.ConclusionMale but not female, normal-BMI CAD patients with increased WC had more severe CAD and a higher risk of one-year re-admission rate.

Pre-pregnancy metabolic syndrome and insulin administration in gestational diabetes: A nationwide population-based cohort study

BackgroundThe present study aimed to evaluate whether mothers with obesity/central obesity and metabolic syndrome before gestation are at higher risk of insulin administration in gestational diabetes mellitus (GDM) to diminish the burden of insulin use during pregnancy. MethodsThis was a population-based retrospective cohort study conducted using data from the National Health Information Database of Korea. We identified all deliveries from January 1, 2011 to December 31, 2015 (N = 1,214,655). Among the deliveries, we identified mothers with pre-pregnancy health checkup records and without previous diabetes history (N = 325,208). Hazards of insulin use in GDM were calculated based on pre-pregnancy obesity/central obesity and metabolic syndrome. ResultsHazards of insulin use in GDM increased proportionately with an increase in the pre-pregnancy body mass index (BMI) and waist circumference (WC). After the adjustment for clinical factors, high BMI group (≥30 kg/m2) and high WC group (≥100 cm) were significantly associated with higher hazard ratios (HRs) (HR 4.161, 95% Confidence interval [CI] 3.381–5.121, P < 0.001 and HR 2.563, 95% CI 1.769–3.712, P < 0.001, respectively). The presence of pre-pregnancy metabolic syndrome significantly increased the hazard of insulin use in GDM (0.54% vs. 5.04%). In the presence of obesity (BMI ≥ 25 kg/m2) or central obesity (WC ≥ 85 cm), HRs of insulin use in GDM were 2.637 (95% CI 2.275–3.056) and 1.603 (95% CI 1.023–2.511), respectively, after adjustment for clinical factors. ConclusionsThe presence of pre-pregnancy obesity/central obesity and metabolic syndrome in Korean mothers is associated with increased risk of insulin use in GDM.

Impact of Body Composition Indices on Ten-year Mortality After Revascularization of Complex Coronary Artery Disease (From the Syntax Extended Survival Trial)

Numerous studies have demonstrated a paradoxical association between higher baseline body mass index (BMI) and lower long-term mortality risk after coronary revascularization, known as the "obesity paradox", possibly relying on the single use of BMI. The current study is a post-hoc analysis of the SYNTAX Extended Survival (SYNTAXES) trial, which is the extended follow-up of the SYNTAX trial comparing percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with left-main coronary artery disease (LMCAD) or three-vessel disease (3VD). Patients were stratified according to baseline BMI and/or waist circumference (WC). Out of 1,800 patients, 1,799 (99.9%) and 1,587 (88.2%) had available baseline BMI and WC data, respectively. Of those, 1,327 (73.8%) patients had High BMI (≥25 kg/m2), whereas 705 (44.4%) patients had High WC (>102 cm for men or >88 cm for women). When stratified by both BMI and WC, 10-year mortality risk was significantly higher in patients with Low BMI/Low WC (adjusted hazard ratio [HR]: 1.65; 95% confidence interval [CI]: 1.09 to 2.51), Low BMI/ High WC (adjusted HR: 2.74; 95% CI: 1.12 to 6.69), or High BMI/High WC (adjusted HR: 1.59; 95% CI: 1.11 to 2.27) compared to those with High BMI/Low WC. In conclusion, the "obesity paradox" following coronary revascularization would be driven by low long-term mortality risk of the High BMI/Low WC group. Body composition should be assessed by the combination of BMI and WC in the appropriate evaluation of the long-term risk of obesity in patients with LMCAD or 3VD.

Change in waist circumference over 2 years and the odds of left ventricular hypertrophy among Chinese children

Background and aimsHigh waist circumference (WC) is associated with left ventricular mass index (LVMI) in childhood. However, no studies have assessed the association between WC change and left ventricular hypertrophy (LVH) in childhood. This study aimed to investigate the association between change in WC status over 2 years on LVH among Chinese children. Methods and resultsData were from a population-based prospective cohort study in China. Children without LVH at baseline (n = 1067) were assigned to four WC status change groups (persistent normal WC, WC loss, WC gain, and persistent abdominal obesity). Over a 2-year follow-up, 103 (out of 1067) children had LVH. LVMI levels were the highest among the persistent abdominal obesity group (31.5 ± 3.8 g/m 2.7), lower in the WC gain group (31.0 ± 3.6 g/m 2.7) and the WC loss group (29.8 ± 3.7 g/m 2.7), and lowest in the persistent normal WC group (29.1 ± 3.7 g/m 2.7). Compared with children in the persistent normal WC group, the odds of LVH was highest in the persistent abdominal obesity group [odds ratio (OR) = 3.57, 95% confidence interval (CI): 2.18–5.83], followed by the WC gain group (OR = 2.85, 95% CI: 1.50–5.41). In contrast, the odds of LVH was not increased in the WC loss group (OR = 0.93, 95% CI: 0.21–4.07). ConclusionAlthough these findings highlight the importance of maintaining normal WC in childhood to reduce the odds of developing LVH, our data suggest the increased odds associated with abdominal obesity can be reversed by WC loss.

Sodium intake assessed by 24-h urine excretion and its relationship with anthropometric measurements in Malaysian adults

BackgroundSodium intake is associated with anthropometric measurement including weight, waist circumference (WC), and body mass index (BMI). Higher intake of sodium is usually linked to higher risk of obesity among adults globally, especially in developing countries. This study aims to explore the probable relationship between sodium intake by 24-h urine excretion assessment and anthropometric measurement of adults in Malaysia.MethodsA cross-sectional study was conducted from October 2017 to March 2018 using a multi-stage stratified sampling method among Malaysian adults aged 18 years old and above. Sodium intake was determined by 24-h urinary sodium excretion, estimated from the respondents’ 24-h urinary sample. Height was obtained based on standard protocol. Weight and WC were measured twice using validated anthropometric equipment and BMI was calculated according to World Health Organization (WHO) 1998 classification. Descriptive analysis was done to describe socio-demographic characteristics. A simple linear regression and multiple linear regression tests were done to assess the relationship of 24-h urinary excretion and anthropometric measurement. All statistical analysis was done using SPSS version 22.0.ResultsOf 1047 interviewed respondents, 798 respondents had done the 24-h urine collection (76.0% response rate). Majority was between 40 and 59 years old (43.5%) and married (77.7%). Simple linear regression showed a significant positive linear association between 24-h urinary excretion and household income, WC, and obese group. In the multivariate analysis, it was indicated that, an increase of 1 unit of BMI will significantly increase the sodium intake by 129.20 mg/dl and an increase of 1 cm of WC will significantly increase the sodium intake by 376.45 mg/dl.ConclusionOur study showed a positive significant relationship between sodium intake estimated by 24-h urinary sodium excretion and BMI of Malaysian adults. More research is suggested on how sodium control can potentially contribute to obesity prevention.

Association of changes in waist circumference with cardiovascular disease and all-cause mortality among the elderly Chinese population: a retrospective cohort study.

BACKGROUNDTo examine the association of baseline waist circumference (WC) and changes in WC with cardiovascular disease (CVD) and all-cause mortality among elderly people.METHODSA total of 30,041 eligible participants were included from a retrospective cohort in China. The same questionnaire, anthropometric and laboratory measurements were performed at baseline (2010) and the first follow-up (2013). The percent change in WC between baseline and the first follow-up was calculated to evaluate three years change of WC. We collected the occurrence of CVD and all-cause death from the first follow-up to December 31, 2018. Restricted cubic splines and Cox proportional-hazards regression models were used to evaluate the relationship between baseline WC/ changes in WC and mortality.RESULTSThe dose-response relationships between baseline WC and CVD mortality were U- or J-shaped. In low WC group, compared with stable group, the fully adjusted hazard ratio (aHR) for CVD mortality was 1.60 (95% CI: 1.24−2.06) in WC gain group among men. In normal WC group, the CVD mortality risk increased with WC gain (men: aHR = 1.86, 95% CI: 1.36−2.56; women: aHR = 1.83, 95% CI: 1.29−2.58). In moderate-high WC group, the CVD mortality risk increased with WC gain (men: aHR = 1.76, 95% CI: 1.08−2.88; women: aHR = 1.46, 95% CI: 1.04−2.05) and risk decreased with WC loss (men: aHR = 0.54, 95% CI: 0.30−0.98; women: aHR = 0.59, 95% CI: 0.37−0.96).CONCLUSIONSFor the elderly population, WC gain may increase CVD mortality risk regardless of baseline WC, whereas WC reduction could decrease the risk only in the moderate-high WC group.

Assessment of the relationship of serum liver enzymes activity with general and abdominal obesity in an urban Bangladeshi population

Obesity is a global health concern because of its increasing trend both in developed and developing countries. A limited number of studies have evaluated the association of liver enzymes with both general and abdominal obesity in the general population; data for the Bangladeshi population are not available yet. This study aimed to assess the relationship of serum liver enzymes activity with both general and abdominal obesity in Bangladeshi adults. In total, 540 blood samples were obtained from the participants (388 males and 152 females) and analyzed for serum levels of ALT, AST, GGT, and ALP using standard methods. General obesity was defined as body mass index (BMI) ≥ 27.5 kg/m2 and abdominal obesity was defined as waist circumference (WC) ≥ 90 cm in males and ≥ 80 cm in females. The relationship between liver enzymes and obesity was evaluated by multivariate logistic regression models. Overall, 58% of participants in the general obesity group and 55% of the participants in the abdominal obesity group had at least one or more elevated levels of liver enzymes. The prevalence of elevated liver enzymes was significantly higher in the obesity group compared to the normal BMI and WC groups (p < 0.05 for all cases). The mean level of serum ALT, AST and GGT were significantly higher in the obesity group than the normal BMI group (p < 0.05). In the WC groups, mean AST and GGT were significantly higher in the obesity group compared to the normal group (p < 0.05). In regression analysis, serum levels of ALT showed an independent and significant association with general obesity, whereas, serum GGT showed a significant association with both general and abdominal obesity. In conclusion, a high prevalence of elevated liver enzymes was observed among participants included in the present study. Of the four enzymes, serum GGT was independently associated with both general and abdominal obesity. Further studies are required to understand the complex relationship between liver enzymes and obesity in the general population.

The prediction of Metabolic Syndrome alterations is improved by combining waist circumference and handgrip strength measurements compared to either alone

BackgroundAdiposity is a major component of the metabolic syndrome (MetS), low muscle strength has also been identified as a risk factor for MetS and for cardiovascular disease. We describe the prevalence of MetS and evaluate the relationship between muscle strength, anthropometric measures of adiposity, and associations with the cluster of the components of MetS, in a middle-income country.MethodsMetS was defined by the International Diabetes Federation criteria. To assess the association between anthropometric variables (waist circumference (WC), waist-to-hip ratio (W/H), body mass index (BMI)), strength (handgrip/kg bodyweight (HGS/BW)) and the cluster of MetS, we created a MetS score. For each alteration (high triglycerides, low HDLc, dysglycemia, or high blood pressure) one point was conferred. To evaluate the association an index of fat:muscle and MetS score, participants were divided into 9 groups based on combinations of sex-specific tertiles of WC and HGS/BW.ResultsThe overall prevalence of MetS in the 5,026 participants (64% women; mean age 51.2 years) was 42%. Lower HGS/BW, and higher WC, BMI, and W/H were associated with a higher MetS score. Amongst the 9 HGS/BW:WC groups, participants in the lowest tertile of HGS/BW and the highest tertile of WC had a higher MetS score (OR = 4.69 in women and OR = 8.25 in men;p < 0.01) compared to those in the highest tertile of HGS/BW and in the lowest tertile of WC.ConclusionWC was the principal risk factor for a high MetS score and an inverse association between HGS/BW and MetS score was found. Combining these anthropometric measures improved the prediction of metabolic alterations over either alone.

Effect of body mass index and abdominal obesity on mortality after percutaneous coronary intervention: a nationwide, population-based study.

Background/AimsWe investigated the impact of obesity on the clinical outcomes following percutaneous coronary intervention (PCI).MethodsWe included South Koreans aged > 20 years who underwent the Korean National Health Screening assessment between 2009 and 2012. Obesity was defined using the body mass index (BMI), according to the World Health Organization’s recommendations. Abdominal obesity was defined using the waist circumference (WC), as defined by the Korean Society for Obesity. The odds and hazard ratios in all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed up to the end of 2017.ResultsAmong 130,490 subjects who underwent PCI, the mean age negatively correlated with BMI. WC, hypertension, diabetes, dyslipidemia, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels correlated with the increased BMI. The mortality rates were higher in the lower BMI and WC groups than the higher BMI and WC groups. The non-obese with abdominal obesity group showed a mortality rate of 2.11 per 1,000 person-years. Obese with no abdominal obesity group had the lowest mortality rate (0.88 per 1,000 person-years). The mortality showed U-shaped curve with a cut-off value of 29 in case of BMI and 78 cm of WC.ConclusionsThe mortality showed U-shaped curve and the cut-off value of lowest mortality was 29 in case of BMI and 78 cm of WC. The abdominal obesity may be associated with poor prognosis in Korean patients who underwent PCI.

Impact of waist circumference on the risk of vertebral fracture: A nationwide cohort study in South Korea.

Evidence on the association between abdominal obesity and vertebral fracture (VF) risk is limited. We examined the association of waist circumference (WC) and abdominal obesity with VF risk in 352,095 South Korean participants aged ≥40years who underwent health checkups between 2009 and 2012. Abdominal obesity was defined by WC ≥90cm in men and≥85cm in women according to the Asian-specific WC cutoff for abdominal obesity. Participants were a representative sample cohort of the Korean National Health Insurance System. The hazard ratios (HRs) and 95% CIs of VF development were determined using multivariable Cox proportional hazard regression analysis. During the 5.5years of follow-up, there were 2030 and 4968 new cases of VF in men and women, respectively. In men, those with abdominal obesity showed an elevated HR (1.11, 95% CI: 1.01-1.23) of incident VF than did those without abdominal obesity. In women, the HRs of VF increased in higher WC groups after adjusting for confounders (P for trend <0.001); the HR decreased in those with WC <75.0cm (HR: 0.81, 95% CI: 0.75-0.88) and increased in those with WC 85.0-89.9cm (HR: 1.12, 95% CI: 1.02-1.22), 90.0-94.9cm (HR: 1.19, 95% CI: 1.08-1.32), and≥95.0cm (HR: 1.27, 95% CI: 1.12-1.43) compared with those with WC 80.0-84.9cm. This association persisted after stratification by age in women. WC and abdominal obesity were positively associated with VF risk in women, and abdominal obesity was associated with VF risk even in men. The consideration of WC and controlling abdominal obesity may be helpful in reducing future VF risk.

Association of waist circumference with muscle and fat mass in adults with a normal body mass index.

BACKGROUND/OBJECTIVESWe aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently.SUBJECTS/METHODSWe analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates.RESULTSWe observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5–18.3), 21.0 (20.6–21.5), 22.1 (21.5–22.8), and 25.1 (24.2–26.1) in men and 29.7 (29.4–30.0), 32.0 (31.6–32.3), 32.9 (32.4–33.4), and 34.7 (33.2–36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m2) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51–7.59), 7.62 (7.56–7.68), 7.65 (7.56–7.74), and 7.22 (7.04–7.41) in men and 5.83 (5.80–5.85), 5.96 (5.92–6.00), 6.03 (5.96–6.10), and 5.88 (5.73–6.03).CONCLUSIONSThere was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.